Most children globally exposed to at least one adverse childhood experience

Adverse childhood experiences (ACEs) are common globally, according to a review published online Nov. 11 in JAMA Pediatrics.

Sheri Madigan, Ph.D., from University of Calgary in Alberta, Canada, and colleagues conducted a systematic literature review to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates.

Based on 65 studies (490,423 children from 18 countries), the researchers found that the estimated mean prevalence rates were 42.3% for 0 ACEs, 22.0% for one ACE, 12.7% for two ACEs, 8.1% for three ACEs, and 14.8% for four or more ACEs. Adolescents versus children (prevalence ratio [PR], 1.16), children in residential care (PR, 1.26), those with a history of juvenile offending (PR, 1.29), and Indigenous peoples (1.63) had higher prevalence rates of four or more ACEs.

Studies with file review as the primary assessment method (PR, 1.29) also had higher prevalence rates of four or more ACEs, whereas the prevalence of no ACEs was lower in questionnaire-based studies in which children versus parents were informants (PR, 0.85).

“Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations,” the authors write.

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